1. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Abnormal Psychology, Eighth Edition by Gerald C. Davison and John M. Neale Lecture notes created by Paul J. Wellman, Texas A&M University PowerPoint  Lecture Notes Presentation Chapter 17 Outcomes and Issues in Psychological Intervention Ch 17

2. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Therapy Evaluation Evaluation of therapy assumes that one can determine the specific procedures that are used in the therapy –How therapy is conducted in practice can be different than what is specified in a therapy manual Efficacy refers to how well a therapy does in a controlled clinical trial Effectiveness refers to how well a therapy does in the real world of practice Ch 17.1

3. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Psychoanalytic Concepts The core issue in psychoanalysis is the removal of repressions that prevent the ego from developing into a healthy person Psychoanalysis lifts repression via –Dream analysis –Free association –Interpretation Psychoanalysis can be of long-duration or can be a brief therapy Ch 17.2

4. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Evaluation of Classical Psychoanalysis Psychoanalytic treatment has been evaluated in only 4 studies –These studies are limited by lack of a control group General findings: –Patients with anxiety disorders do better in psychoanalysis than do schizophrenic patients –Better educated clients do better in therapy –Interpretation by the therapist may not be helpful for the therapy process Ch 17.3

5. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Humanistic psychotherapy assumes that people must be understood from their own point of view –Psychological disorders arise when people fail to appreciate their own internal worlds –Therapist role is to be accepting of the client and to be non-judgmental Positive outcomes are not always related to therapist empathy Evaluation of Client-Centered Therapy Ch 17.4

6. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Gestalt psychology holds that the goal of therapy is to make people aware of their own basic needs and desires –People create their own existence There is a general lack of research on the effectiveness of Gestalt therapy –Some of the technique associated with Gestalt therapy (e.g. the empty-chair) have been shown to reduce self-rated anger Evaluation of Gestalt Therapy Ch 17.5

7. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Evaluation of Counterconditioning Systematic desensitization involves having a deeply relaxed person imagine a series of fear- inducing situations Systematic desensitization is effective for the treatment of anxiety-related problems –Simple phobias, agoraphobia –PTSD –Obsessive-compulsive disorder –Panic disorder Ch 17.6

8. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Evaluation of Operant Methods Operant methods involve the systematic rewarding of desirable behaviors and extinguishing undesirable behaviors Operant methods are effective for a wide range of behavioral problems, particularly in children Caveat: The problem behavior must be an operant (i.e. under the control of a contingent reinforcer) Ch 17.7

9. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Evaluation of Rational- Emotive Behavior Therapy Rational-emotive behavior therapy (REBT) acts to remove unreasonable cognitive beliefs REBT has been shown to –Reduce self-reports of anxiety –Improve self-reports of social anxiety –Alter anger, depression and antisocial behavior –Reduce the Type A behavior pattern Ch 17.8

10. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Evaluation of Beck’s Cognitive Therapy People in emotional distress operate under cognitive schemas that are disabling –The goal of Beck’s cognitive-behavioral therapy (CBT) is to challenge these schemas CBT has been shown to –Improve depression and to prevent future depression episodes –Be comparable to drug therapy in overall effectiveness for the treatment of depression Ch 17.9

11. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Generalization/Maintenance of Treatment Effects Generalization seeks to identify the factors that allow clients to maintain treatment-related gains while in the real world –Using intermittent and natural reinforcers is helpful –Eliminating secondary gain –Reducing the likelihood of relapse by encouraging clients to attribute their slips to external, unstable, specific and controllable factors –Attribution of treatment gains to oneself may be useful for the person Ch 17.10

12. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Evaluation of Couples and Marital Therapy The focus of couples and family therapy is on improving communication Family/couples therapy is –More successful in conjoint therapy than individual therapy –Successful in reducing relationship stress –Not always clinically significant Depression/low frequency of sexual behavior can be predictors of poor outcome Ch 17.11

13. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Review of Community Psychology The focus of community psychology is prevention of disorder Community psychology has been useful in –Prevention of cigarette smoking –Prevention of HIV infection –Reducing the risk of cardiovascular disease Community psychology efforts do not work when the disorder of interest is not subject to social/environmental change Ch 17.12

14. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Psychotherapy Integration Integration seeks to determine the common ground among the various therapy schools –Technical eclecticism refers to a situation in which a therapist uses techniques from other disciplines, without adopting the theories that spawned them –Common factorism seeks strategies that are common to all therapy schools –Theoretical integration attempts to synthesize both theory and technique across schools Ch 17.13

15. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Cultural Issues in Therapy Cultural diversity is the norm in the United States –There is an assumption, not proven, that clients do better in therapy with therapists who are similar to the client in cultural and ethnic background –Therapists need to understand the cultural background of their clients Ch 17.14

16. © 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Copyright Copyright 2000 by John Wiley & Sons, New York, NY. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission of the copyright owner.